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California rates for HCPCS L5984

All Endoskeletal Lower Extremity Prostheses Axial Rotation Unit With Or Without Adjustability (Rvsd 1/1/04)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$410.66 / $410.66 / $2,630.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.88 / $410.66 / $2,630.36
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.16 / $638.16 / $638.16
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$311.85 / $1,284.70 / $2,893.85
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$378.67 / $414.81 / $721.88
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.00 / $1,079.32 / $1,927.36
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $1,209.61 / $2,817.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.41 / $427.25 / $487.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.89 / $311.89 / $455.47
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.05 / $405.66 / $1,002.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.99 / $638.16 / $1,385.71
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,495.98 / $3,613.43 / $4,330.34
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,729.14 / $4,842.63 / $5,128.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,654.18 / $1,654.18 / $1,654.18
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$220.22 / $791.90 / $914.18
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.89 / $427.25 / $825.28
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,720.72 / $1,720.72 / $1,720.72
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.05 / $574.69 / $729.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.08 / $400.63 / $919.79